A young woman presents with hypertension and a renal artery aneurysm. This combination most strongly suggests which condition?

A young woman presents with hypertension and a renal artery aneurysm. This combination most strongly suggests which condition?

• A. Atherosclerosis
• B. Renal Cell Carcinoma
• C. Fibromuscular Dysplasia
• D. Malignant Hypertension

Answer: (C)

Renovascular hypertension due to fibromuscular dysplasia is the best fit here. In young women, fibromuscular dysplasia is the most common cause of renal artery stenosis, which lowers perfusion to the kidney and activates the renin–angiotensin system, driving high blood pressure. The disease is non-atherosclerotic and often affects medium-sized arteries, producing segments of narrowing and sometimes aneurysmal dilation—the renal artery aneurysm can occur as part of these vascular changes. This pattern and demographic are less compatible with atherosclerosis (more common in older individuals with risk factors), renal cell carcinoma (would typically present with hematuria, flank pain, a palpable mass), or malignant hypertension (a severe hypertensive state rather than a characteristic renal artery lesion in a young patient).

Renovascular hypertension due to fibromuscular dysplasia is the best fit here. In young women, fibromuscular dysplasia is the most common cause of renal artery stenosis, which lowers perfusion to the kidney and activates the renin–angiotensin system, driving high blood pressure. The disease is non-atherosclerotic and often affects medium-sized arteries, producing segments of narrowing and sometimes aneurysmal dilation—the renal artery aneurysm can occur as part of these vascular changes. This pattern and demographic are less compatible with atherosclerosis (more common in older individuals with risk factors), renal cell carcinoma (would typically present with hematuria, flank pain, a palpable mass), or malignant hypertension (a severe hypertensive state rather than a characteristic renal artery lesion in a young patient).